Provider Demographics
NPI:1336283449
Name:SCHMITT, KEITH A (RPH)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:A
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 ACORN CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-6739
Mailing Address - Country:US
Mailing Address - Phone:812-473-0665
Mailing Address - Fax:
Practice Address - Street 1:1550 VANN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-3359
Practice Address - Country:US
Practice Address - Phone:812-469-7435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014386A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist